Why I Prefer Botox over Dysport

I have been a faithful Botox user now for a decade and recently experimented with Dysport.  Although I have nothing against Dysport as a product, it has not worked well in my hands.  For all the many questions that my patients ask me about it, I would like to clarify why I have not liked Dysport, at least not at this time.

I have tried two rounds of Botox and Dysport split face evaluations in Constanze, my patient care coordinator.  Constanze is in her fifties and has been getting steady Botox from me over the years.  Despite these treatments, her crow’s feet are particularly difficult to manage since she waited a longer time to start and she just has crepier skin in this area.  Not only did I evaluate her after the treatment but I had my staff (who did not know which side I injected with which product) evaluate her.  The consensus was that the Botox treated side won hands down even with a second round where I increased the Dysport dose quite high.

Why should this be the case?  The reason is that I use a different dilution of Botox and am able to spread out my dosage across a wider area than what I can with Dysport, which in its current bottle configuration can only permit a very concentrated version.  To put it another way, I cannot distribute Dysport over a wide area like the forehead or across the crow’s feet with the level of precision that I can with Botox.  The one area that I think the results are near identical is in the glabellar frown lines.  I have not noticed a huge difference here, most likely because I concentrate my Botox dose in this area as I would have to do with Dysport.

I think that for other providers Dysport can work as well as Botox and in many providers’ hands even better than Botox for the following reason.  Dysport tends to diffuse over a wider area than Botox.  When someone injects only a few spots across the areas of the face rather than doing the multiple micro injections that I am accustomed to perform I think Dysport may actually be better.   I actually truly like the fact that Botox does not diffuse everywhere.  I can stay focused with my injections so that they do not spread to areas that I did not intend.  Yes, that requires significantly higher number of injection points but fortunately my method is so painless (literally you cannot feel my needles) that I can do this with great impunity.

I never say never, as my thoughts are constantly in evolution and I may find a role for Dysport in my practice in the future.  Again, this article is not a negative on Dysport, which I think is a good product.  It just does not work in my practice for the above-stated reasons.

Samuel M. Lam, MD, FACS is a board certified facial plastic surgeon in Dallas, Texas. To learn more about Dr Lam’s Botox procedures please call (972.312.8105 to schedule a consultation. If you would like to ask Dr Lam a question about Botox please visit our Botox forum.